Florida Public Health: A Continuing Legacy of Essential Services


Uploaded by fldoh on 07.12.2009

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Floridians enjoy an enviable quality of life. A pristine natural environment, unique to our nation -- miles of unspoiled beach, -- acres of untouched forest and wetlands,-- An abundance of fresh water and clean air A national leader at the start of the 21st Century -- Florida enjoys spectacular environs ---- the wealth of a thriving, international economy, and the vibrancy of a diverse, multicultural populationOur stateís natural and human resources contribute to an unparalleled climate of health and well-being.-- A healthy Floridaís future.Invisible to most Floridians, is the network of professionals, processes, and services that stand in place to maintain and safeguard the health and safety of all Florida residents and visitors. But it hasnít always been this way.To appreciate how far weíve come ñ letís turn back the clock to a time when Florida ñ and its health -- were profoundly different.
In its early history, Florida was the nationís backwater. It was originally populated by Native Americans ñ who fell victim to diseases -- from which they had no immunity . Settlers ventured no farther than south of Gainesville, instead, traveling the Panhandle by wagon, on trails that had been cut through the thick pine forests. The southern part of the state was virtually uninhabited but for pockets of Seminole Indians who had escaped relocation. South Florida was a sea of grass, marsh, mangroves and swamp -ñ a mosquito and alligator infested no-manís-land, where few settlers ventured.The stateís sweltering tropical climate, primitive frontier living conditions, poor sanitation, scant health care and -- most of all ñ its wealth of lakes and marsh ñendless breeding grounds for disease carrying mosquitoes -- made life in Florida nasty, brutish and short. Throughout the century, smallpox, malaria, yellow and dengue fever, diphtheria, typhoid, pertussus and encephalitis were endemic, ravaging Floridaís scant population.When the state board of health was established in 1889 its purpose was the treatment, prevention and eradication of disease and the conditions that foster illness. Over the past 100 years, the state board of health, evolved into todayís Department of Health. And, while the fundamental mission stays the same it has adapted and changed, to meet the public health challenges of Florida in the 21st Century .
ìI boarded a Spanish schooner and demanded of the captain to look at his papers (for a health inspection)Ö. they at once set upon me and threw me overboard, and then cut loose my boat Ö leaving me to find my boat as best I could, Please instruct me what to do, as the vessels from Cuba invariably threaten me or refuse to let me board them (for inspection)Ö if you order I will board them with my Winchester, and use it if actually necessary. When will my duty here cease? Please Advise.îLetter from Morris Cochran, State Board of Healthís maritime inspector, in a letter to SBO Officer Dr. Porter, 1890
Preventing the introduction and spread of disease has never been an easy job. But then and now, itís a critical part of Florida Department of Healthís mission ñ achieved today through the delivery (of 10) essential health services Central to the task of diagnosing and investigating health problems and hazards is the work done by state epidemiologists These disease detectives ñ have the challenge of investigating and preventing the outbreak of infectious and chronic diseases. Their job is to quickly learn as much as possible about a disease and indicatorñ which is critical to preventing the disease from spreading. This important work is epitomized by Florida epidemiologistsí nationally recognized role in response to the onset of the AIDS epidemic in the 1980s, and its more recent efforts, investigating, tracking and preventing mosquito related diseases like St. Louis Encephalitis and West Nile Virus.
The Department of Health monitors and tracks community health issues using data constantly gathered from throughout the state. The stateís birth, death, marriage, and divorce records are collected, analyzed and maintained by the Department.Detailed statistics for monitoring where health problems are occurring, the number of people affected and the stateís response are gathered and studied continuously. Florida uses as a state-of-the-art, web based surveillance system for monitoring communicable such as measles and pneumonia and chronic diseases such as heart disease, diabetes and stroke.
ìWe find, . . all householders and tenters must use galvanized iron slop buckets in all closets, pour all kitchen slops and refuse in bucketsóall of which must be carried and thrown into the river....î Miami Metropolis news story 1880s(As reported in the Journal of the Florida Medical Association Vol. 59, No. 6 pp 54¨62 August 1971.)
The environment wasnít a pressing concern in early Florida. Today, maintaining clean water, safe foods and sanitary living conditions ñ things key to the quality of life in Florida ñ are required by Law. The Department of Health is charged with the responsibility for making sure these laws are enforced.Each year public heath professionals monitor and inspect thousands of public and private facilities and services such as community water supplies, X-ray machines, , pools and drinking fountains, day care centers, migrant labor camps, mobile home parks, sewage treatment plants, hazardous waste sites, body piercing and tattoo salons, public beaches and more. The range of monitoring is almost unfathomable ñ most anyplace or anything that might expose a Floridian to a contaminant and disease --These are largely unseen and unheralded services, with the hands-on-inspections being provided by professionals in Floridaís 67 County Health Departments.
Since 1911, investigative findings ñ whether sample materials from an unsafe environment or specimens collected for evidence of communicable disease ñ have made their way to the Department of Healthís State Laboratory.The state labs provide an array of mostly unseen services For instance, within several minutes of coming into the world a newborn infantís blood is sampled, and sent to the state lab for diagnostic screening, where itís checked for metabolic disorders and other diseases -- so if found, the infant can receive speedy treatment.The lab has the facilities and well trained professionals to quickly respond to public health emergencies, providing research based findings and analytical information essential to confronting public health threats ñ which in todayís world include biological, chemical, and radiological attacks. 00:06:59,00 --> 00:07:26,00 ìI have visited all the tuberculosis patients possible, advised and instructed them how to live for their own good, and for the protection and welfare of those around them. While there are many hardships and discouragement in this work, I find that as people understand what we are trying to do, and that our only object is to help them, they more fully appreciate our servicesÖ
To inform, educate and empower people about health issues is an essential service of todayís department of health and a strong public health tradition, going back to the 1800s. In, what was undoubtedly one of the more inventive health education approaches, the State Board of Health created the ìhealth trainî described as (quote) ìa three-car train of health exhibits including moving pictures, models, electric devices, panel texts other instructional devices and printed materials.î (unquote) It was used to bring essential health information to rural populations throughout the state.
Florida has continued to be on the cutting edge of health education. More recently, Floridaís successful campaigns to prevent and eliminate tobacco use among teenagers has become a national model. Additional educational efforts are focused on Heart Disease and Stroke, Diabetes, Obesity, Arthritis, sexually transmitted diseases including HIV/AIDS , Sexual Violence, birth defects, cancer, maternal and child nutrition, childhood diseases, alcohol abuse and more. And while modernizing its approach, confronting the problem of ìlife styleî diseases has been central to Public Healthís mission for more than half a century:
Assuring that nurses and other Florida health care professionals are part of a competent workforce is another essential service provided by the Department of Health. Health care professional licensing and oversight is the responsibility of the departmentís Medical Quality Assurance program. This program ensures that Floridaís health care professionals --- including doctors, nurses and emergency medical technicians ñ meet the exemplary standards of their individual professions.
Ensuring access to health care for Floridaís disenfranchised ñ people and families, who because of economics or adverse circumstance, lack access to even the most basic health care services -- is a Florida public health commitment. The department works to link people to needed personal health services and assure the provision of health care when otherwise unavailable.
Today, the health care spot light seems to only focus on the sensational stories. Too frequently overlooked are the dire circumstances faced by 30 percent of Floridaís population: individuals and families who are uninsured, underinsured or without access to the most fundamental health care treatments. Floridaís County Health Departments provide a health care safety net for these Floridians.The first County Health Department was established in 1930 in Taylor County. Today, there is a county health department in every Florida county. Then and now, county health departments are on the front line of community health care and disease prevention and treatment. Local health departments provide a range of services in communities throughout Florida. Essential services such as .CONFIDENTIAL TESTING for AIDS and testing and treatment for other sexually transmitted diseases IMMUNIZATIONS -- to protect children from diseases such as diphtheria, meningitis, measles, mumps and tetanus, ADULT HEALTH CARE which provides a range of basic medical care services and treatments to those in need.HEALTHY START ñwhich offers free screening counseling to pregnant women CHILD HEALTH services ñ such as physical examinations for infants and children who are about to enter school or pre-school. CMS many clinical interventionsNUTRITIONAL COUNSELING to develop -- healthful eating among people who need special diets because of illness or medical conditions. WIC -- The Supplemental Food Program for Women, Infants and Children (WIC) provides eligible mothers and children up to age 5 with food coupons to purchase specific nutritious foods needed for healthy dietsDENTAL HEALTH services including treatment to indigents and preventive care to school children.
ìEverywhere the eye could see was a litter of uprooted trees, overturned telephone poles, splintered bits of houses, battered boats and here and there a smashed body protruding from under the debris, floating in an inlet or half buried in the sand. The extraordinary havoc was wreaked by both wind and water. Giant wind fingers traveling at more than 200 miles an hour. . rolled up a monstrous tidal wave. . nearly 20 feet high. . that. . crashed on the hapless keys.
Local public health departments began a role responding to natural disasters beginning with the deadly and monumentally devastating Florida hurricanes in 1926 and 1935. More recently, in 1992, after Hurricane Andrew caused massive damage to South Florida, public health environmental professionals responded to the stormís related health threats such as contaminated water, compromised sewage disposal, sanitation related illnesses and more. Nearly 250 people died in the 1926 hurricane and 408 perished in the 1935 storm. Fortunately, Andrewís death toll was limited to 26.
Fewer casualties from a natural disaster, cleaner drinking water, lower infant mortality rates, eradicated deadly diseases, healthier children ñ these are just a few public health milestones during the past 100 years. So much has been done ñ in such a relatively short time ñ because of two additional and related essential public health services ñ evaluating the present and planning for the future.
The Florida Department of Public Health continuously evaluates its performance, analyzing and measuring whatís being done, what needs to be done, what can be done better in the wide range of programs and services it provides.
Findings are used to formulate new policies, to set new goals and to develop tangible plans for improve existing programs and to prepare for the future. From disaster planning, to planning for new programs to long range strategic planning ñ evaluation and planning are the foundation for better services.
In 1920 Florida Womenís Clubs and the former State Board of Health joined hands to collectively develop school health and maternal and child health programs. Early on, Floridaís public health leadership recognized that they couldnít do it alone ñ and the benefits of importance of community partnerships. Today, the partnership tradition continues, as the Florida Department of Health initiates a wide range of partnerships with nonprofit organizations, private contractors and local health care providers. The result: local problems being resolved with local solutions and a cost effective combination of local, state and federal dollars and talent
ìThe duty of preserving the health and lives of its citizens from the causes of disease is as incumbent on the state as that of suppressing rapine and murder. . One has no adequate conception of how much sickness and consequently death, are preventable. . .î
Weíve just scratched the surface of the broad range and scope of Floridaís Department of Health roles and services but thereís so much more ñ like the Childrenís Medical Services program that provides medical services to kids and families with special needs ñ using such cutting edge technologies as telemedicine, or the KidCare Program which offers health insurance for uninsured children and or specialized programs like the Brain and Spinal Cord injury program. And, this brings us to the last, yet equally important essential service:
Itís so often said ñ but no less true ñ that we live in a swiftly changing world offering us the daily wonders of new technologies, new dark and not so distant threats and unimaginable possibilities for the future. In this environment, the Department of Health recognizes that ongoing research ñ looking for new insights and innovative solutions ñ is an essential health service.The Florida Department of health has a proud legacy and, equally importantly, the professionals, commitment and skill to meet the public health challenges of the future.